Auscultation is a fundamental practical skill in medical education, serving as a crucial diagnostic tool for identifying respiratory disorders. Mastering this technique requires a deep understanding of normal respiratory sounds. However, the effectiveness of auscultation is inherently limited by the examiner’s expertise, auditory perception and the acoustic properties of the stethoscope used. Advancements in medical technology have introduced electronic stethoscopes, which amplify and filter sounds, potentially enhancing the sensitivity and specificity of auscultation. While these devices offer significant advantages in detecting subtle pulmonary abnormalities, their effectiveness in recognizing normal breath sounds compared to traditional acoustic stethoscopes remains an area of exploration in medical education. We hypothesize that the electronic stethoscope, providing greater sensitivity than the acoustic stethoscope, may help refining and enhancing students diagnostic perception during auscultation.
In this study we tested an educational experience, in which medical students compare the performance of acoustic and electronic stethoscopes in identifying normal respiratory sounds. In the first session, the students learn identifying key acoustic characteristics of normal breathing sounds during the respiratory cycle and its variability, initially with an acoustic stethoscope and later, with an electronic stethoscope, using headphones with noise cancellation. In a latter session, a complete anatomical lung auscultation cartographic mapping is carried through the major projection areas, determining which sound is predominantly found in each anatomical location, according to their own perception. Sensitivity and specificity for all data points, and sounds, was calculated. Pre-session and post-session tests were carried to assess conceptual assimilation regarding respiratory sounds interpretation. Students perception, performance, as well as satisfaction, was evaluated by means of online and instant-feedback questionnaires.
Analysis of respiratory sounds using pre-recorded sounds as well as real-time respiratory sounds via electronic stethoscope (connected to speakers) allowed identifying and discussing acoustic characteristics of laryngotracheal, bronchovesicular, and vesicular sounds in normal conditions in detail. By evaluating different individuals, students gained a more comprehensive understanding of lung sound variations, fostering deeper learning and refining their auscultatory skills. Sensibility and precision accuracy identifying respiratory sounds and its characteristics were found higher for the electronic stethoscope. According to students perception the electronic stethoscope allowed them to identify subtle physiological and non-physiological modifications of normal respiratory sounds. Additionally, we found increased satisfaction and perception of learning. Post-session questionnaires showed increased conceptual assimilation. As expected sound classification and technique performance were significantly better after the experience.
Both acoustic and electronic stethoscope allowed medical students to identify normal respiratory sounds and its characteristics, yet the latter with higher sensitivity and accuracy. Educational challenges regarding auscultation persist, both in theory and practice, yet the electronic stethoscope may also serve as a tool for redressing practical and instrumental auscultatory and diagnostic skills.

Keywords: Auscultation, Electronic/Digital Stethoscope, Instrumental learning, Acoustic Stethoscope, Innovations in Medicine Education, Technology-enhanced learning.